Recent Reflections – 14th April 2015

Over the last couple of weeks I seem to have become embroiled in row on social media that started with a tweet from Jim Thornton, professor of obstetrics at the University of Nottingham.
I won’t repeat the full background as Jim has recently written an excellent blog summarising what happened here.
I first became aware of Jim’s tweet from the responses to it, which included allegations that Jim’s actions were ‘very unprofessional’, a comment that was intentionally copied to the RCOG. This reaction, Jim admits, made him feel sufficiently ‘nervous’ to ‘keep his head down’.
As Jim mentions in his blog, the main reason for this reaction was the fact that he had copied in Amy Tuteur. Tuteur is a retired US obstetrician who blogs about homebirth and normal birth.  Tuteur’s views are considered very controversial by some, especially her uncompromising opposition to homebirth. Over the years (and I get the feeling that the history goes back some time), the levels of animosity between Tuteur and some UK midwives and midwifery leaders (at least those active of social media) has risen to extraordinary levels. Tuteur is regularly dismissed as a ‘troll’. The exchanges that do happen are usually acrimonious and heated on both sides.
For my part, I’ve been aware of Tuteur for a number of years and have regularly read her blogs (by no means agreeing with everything but certainly feeling that some of the issues raised are important and valid). It was reading one of Tuteur’s blogs back in the early days after the death of my son following care at Furness General Hospital (FGH) that made me first aware of the RCM’s ‘campaign for normal birth’. Around this time, I started to learn more about other deaths at the maternity unit at FGH that seemed to paint a similar pattern of midwives acting inappropriately to keep doctors away and thus preventing interventions that could have resulted in different outcomes. Tuteur’s blog resonated with my experience and made me question what the RCM’s campaign was trying to achieve and what influence it had on the problems at FGH that contributed to so many avoidable deaths.   
More recently, Tuteur has written blogs about observations made relating to the way I’ve been treated on social media as I’ve attempted to debate some of the issues relating to maternity care that I feel strongly about. Being honest, it’s been a real struggle. There have been times when I’ve felt dismissed, disheartened and even hurt. Whilst I’ve been saddened and frustrated by this,  I haven’t had any involvement in the blogs that Tuteur has written which mentioned me and having read them, I’ve made it clear that I don’t approve of their personal nature nor do I condone the approach. 
What has really surprised me though, is observing that even the mere act of copying Tuteur into a tweet led to a respected professor of obstetrics being accused of being ‘very unprofessional’ and the veiled threat of copying in the RCOG. For me, this crosses a line. As users of social media we have an absolute right to choose who we engage with and to block/ignore or mute those we wish. However, I don’t think it’s right that any person or group of people should decide that someone is so unacceptable to them, that they monitor who else engages with them and make very serious and public accusations about the professional conduct of anyone who does. 
I do think that this is a form of bullying.  At the time I expressed a view that Jim had a right to copy in whomever he wished. Since doing so, the attention quickly turned to me. I was accused of having some form of ‘liaison’ with Tuteur and attention quickly drawn to my role on the national maternity review panel. Tweets have also been copied to my employer. 
So, let me be clear about my position. I don’t agree with everything Tuteur writes. I do however think some of the points she makes are valid. If Tuteur makes a comment on Twitter that is valid and thought provoking, like the Tweet Jim refers to at the end of his blog, I won’t be intimidated into feeling that I can’t retweet it. We can’t seek to close down people simply because we don’t agree with their views. However, I also think that it’s important that when using social media we are mindful and considerate of people’s feelings and sensitivities. I won’t contribute to any debate, on social media or otherwise, that is deliberately antagonistic or disrespectful of people’s experiences and professionalism. 
Having seen (and been quite shocked) by the debate which has unfolded following Jim’s tweet, I think this is something others would do well to reflect on.

2 thoughts on “Recent Reflections – 14th April 2015

  1. Mabel

    Mr Titcombe-you are handling this situation with grace, charity and far more respect and thoughtfulness than those who have sought to silence you have done. Their behaviour has been frankly disgraceful-it is absolutely bullying, it’s vicious, threatening and grossly unprofessional. I would like to see Ms Byrom’s justification for some of the comments she has made to you such as ‘Don’t lets get on that roll again’, or sarcastic sneers such as ‘getting out of bed has risks’. How can someone who dismisses a person who lost their baby in the worst of circumstances possibly be held up as a role model? Quite frankly, the chorus of people falling over themselves on twitter supporting her views seem deluded in the extreme.

    I agree with you about Dr Tuteur-she has an abrasive and harsh tone at times, but I think underlying this is a genuine concerns that babies are dying unnecessarily because of ideology. However, very often the situations she describes are not directly comparable to the UK-the licensing and training systems of midwives is different and she has made it clear in the past that she has no issue with certified nurse midwives who are trained to an extremely high level, equivalent to UK trained midwives, but with certified professional midwives with rather less rigorous training.


  2. Angela Clipstone

    I followed the spat on Twitter and have to say was astonished. The stance taken by some gives outsiders very little faith that anything other than a ‘it’s my way or the highway’ approach is entrenched. Very worrying. Particularly found the telling the teacher bits toe curling. I’m new to Twitter, it hasn’t put me off though, quite the opposite in fact.

    Kind Regards.



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